Eradicating Depression Through Schema-Focused Therapy

Samantha moved to a large sprawling city to join her boyfriend.  They carried on a long-distance relationship prior to her decision to move in with him.  Unfortunately, the relationship did not last long, and she felt stuck in a city without a plan to move forward in a positive direction – she sank into a deep depression.

This young lady had parents who were extremely passive and detached.  Having lived in a rural town, her options for activity were limited.  Her parents never encouraged involvement in outside interests.  She lacked confidence and was timid around age-mates.  Having moved numerous times during childhood, it affected her ability to build trust and closeness.  She felt alone in managing her problems. 

Samantha came to therapy looking for a way to lift her debilitating depression.  She felt sad, grief-stricken, hopeless, unmotivated and unwilling to seek out new friendships.  She was troubled by a set of underlying schemas (assumptions) that clouded her worldview and activated depression.  These schemas crystallized in response to unmet needs derived during childhood.  The schemas were activated anytime that Samantha encountered problems associated with negative beliefs.  The schemas that activated depression were:

• "I'm all alone in my problems."

• "I'm not good enough."

• "I don't trust that others will be there for me."

• "Life looks bleak.  I feel hopeless."

These core schemas around the theme of depression were activated when my patient encountered the following life situations:

• Trying to establish friendships

• Pursuing intimate relationships

• Facing new problems

• Attempting to change directions in her life

• Trying to get motivated professionally

• Envisioning a positive future

Samantha worked diligently in therapy to alleviate her depression through untwisting her negative thinking.  We gently challenged her core schemas by looking for evidence to the contrary.  She gained hope in eradicating her depression as we refuted faulty schema-based thinking.  She eventually began to respond more rationally and adaptively:

• "I can manage this friendship-making business."

• "I'm not ready for an intimate relationship now, but when I am, I’ll feel confident and will be more selective."

• "I can cope with and manage new problems."

• "I am certain that I can re-create my life."

• "If a chunk things down into smaller pieces, I can set goals and get motivated."

• "The future holds new opportunities." 

Samantha "connected the dots" by understanding the relationship between her core depressive schemas and current behaviors.  As a result, she was able to modify her current thinking to make it more hopeful and less depressing.